Ortostatska hipotenzija

master's thesis

• Title (english): Orthostatic hypotension
• Author: Nina Vrsaljko
• Mentor: Mario Habek (mentor)
• Committee member: Maja Relja (predsjednik povjerenstva)
• Committee member: Damir Petravić (član povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Ortostatska hipotenzija se definira kao trajni pad sistoličkog tlaka za više od 20 mmHg i dijastoličkog za više od 10 mmHg unutar 3 minute od promjene položaja tijela iz ležećeg ili sjedećeg u uspravni. Posljedica je neadekvatnog fizološkog odgovora krvnog tlaka na promjenu položaja tijela, a može asimptomatska i simptomatska. Pojavljuje se u svakoj dobnoj skupini, ali prevalencija raste s dobi. U općoj populaciji prevalencija ortostatske hipotenzije je oko 0.5%, dok je kod osoba starijih od 65 godina je između 5 – 30%. Česti simptomi su vrtoglavica, zamagljen vid, slabost, iscrpljenost, mučnina, palpitacije i glavobolja. Ortostatska hipotenzija može biti prvi znak zatajivanja autonomnog živčanog sustava, pa je čest simptom u primarnim i sekundarnim bolestima autnomnog živčanog sustava (multisitemnoj atrofiji, Pariknsonovoj bolesti, dijabetičkoj autonomnoj neuropatiji), ali češće je nuspojava lijekova poput diuretika i antidepresiva, te posljedica hipovolemije. U obradi bolesnika s ortostatskom hipotenzijom bitno je tražiti potencijalno reverzibilan uzrok ili bolest u podlozi i ciljano ih liječiti. Iako je ortostatsku hipotenziju teško liječiti, cilj je smanjiti simptome i poboljšati kvalitetu života. Liječenje može biti farmakološko i nefarmakološko. Nefarmakološko podrazumijeva promjene životnog stila i preporuča se svim bolesnicima. Onima koji ne reagiraju daju se lijekovi poput fludrokortizona, midodrina i piridostigmina.

Abstract (english)

Orthostatic hypotension is defined as a sustained decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic response to postural changes in blood pressure. Orthostatic
hypotension may be symptomatic or asymptomatic. It occurs in all age groups, but the prevalence increases with age. In the general population the prevalence of orthostatic hypotension is 0.5%, whereas in patients older than 65 years is between 5-30%. It may be the first sign of dysfunction of the autonomic nervous system and is a common symptom in primary and secondary diseases of autonomic nervous system (multiple system atrophy, Parkinson's disease, diabetic autonomic neuropathy), but more often is a side effect of medications such as diuretics and antidepressants, as well as a consequence of hypovolemia. Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, and headache. Evaluation of suspected orthostatic hypotension begins by identifying reversible causes and underlying associated medical conditions. Although it is difficult to treat orthostatic hypotension, the goal is to reduce symptoms and improve quality of life. Treatment can be pharmacological and non-pharmacological. Non-pharmacological
involves lifestyle changes and is recommended for all patients. For patients who do not respond adequately to nonpharmacologic treatment, fludrocortisone, midodrine, and pyridostigmine are pharmacologic therapies proven to be beneficial.

• Keywords: ortostatska hipotenzija; autonomni živčani sustav; krvni tlak
• Keywords (english): orthostatic hypotension; autonomic nervous system; blood pressure
• Language: croatian
• URN:NBN: urn:nbn:hr:105:842477
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-12 10:08:41